I HUMAN Cases Week 7 Is the inability to urinate an emergency or should you tell Ms. Burd to continue to monitor Noodle for the rest of the day with detailed correct answers 2024 GRADED A+

I HUMAN Cases Week 7 Is the inability to urinate an emergency or should you tell Ms. Burd to continue to monitor Noodle for the rest of the day with detailed correct answers 2024 GRADED A+ Is the inability to urinate an emergency or should you tell Ms. Burd to continue to monitor Noodle for the rest of the day? - ANSWER-Inability to urinate is an emergency and should be treated right away What does BUN stand for? What organ does a BUN test evaluate? - ANSWER-BUN is Blood Urea Nitrogen - product of protein metabolism filtered out by kidneys. When glomerular filtration rate is decreased or urinary tract is obstructed, urea nitrogen will build up in blood stream. Kidneys are unable to fully filter out urea nitrogen out of the vascular system causing BUN levels to decrease. What other blood chemistry values may be altered in a patient with a urethral blockage, especially with longer-term blockage? - ANSWER-It is important to monitor blood pH; potassium levels of many animals with urethral blockages will become hyperchloremic and acidotic which can be life threatening. What is urohydropulsion? - ANSWER-Procedure used to clear urethra of foreign materials in male dogs. Urinary catheter is inserted and fluids injected into urethra while prepuce is closed shut. Urethra caudal to obstruction is also held shut rectally allowing fluid to expand urethra and hopefully flush the stone backwards into the urinary bladder. Why would cystocentesis be the best method to collect urine and partially empty Noodle's bladder? - ANSWER-Cystocentesis is best method to collect urine. Noodle is blocked so catheters, free catch, and expression are not viable. Cystocentesis will allow for emptying of the bladder and urine sample collection. Why should urine collection be done before starting urohydropulsion? - ANSWER-After urohydropulsion, bladder will have saline and lubricants in it which would alter the results of the urinalysis rendering findings invalid. What equipment is needed to perform urohydropulsion? - ANSWER-Urohydropulsion requires urinary catheter, large syringe with a catheter tip, sterile saline, exam glove, and lubricant. Ideally largest urinary catheter possible is used because a tight fit is best for this procedure. Is this USG within normal range? What is the proper method for preparing a urine sample for a microscopic sediment examination? - ANSWER-Is slightly higher than average USG but still in the normal range. To prepare urine sample for sediment you would take the urine and place into centrifuge tube and centrifuge for 3-5 minutes and drop off most of the supernatant and leave ½ to 1 mL in the centrifuge tube then suspend sediment in the fluid by flicking the tube carefully or mixing with a pipette. Drop of mixed liquid is transported to a microscope slide and evaluated. Stain can be added if desired and a cover slip is placed over the liquid. What is a benefit of using a stain when examining urine sediment? What are some problems that are associated with staining urine sediment? - ANSWER-Staining urine sediment can improve differentiation between cell types, however, it can introduce artifacts like bacteria or other precipitate material. What are some other names for struvite crystals? Describe the appearance of struvite crystals. - ANSWER-Struvite are frequently called triple phosphate or magnesium ammonium phosphate. Resemble coffin lids and are generally 6-8 sided prisms with tapered sides. Is Noodle's acidic, neutral, or alkaline? How does diet affect urine pH? - ANSWER-Slightly alkaline; alkaline urine most common in animals who have plant material based diet and acidic is mostly commonly seen in animals with a meat or animal based diet. Omnivores can have neutral, acidic, or neutral urine. Name two crystals that form in acidic urine, two in alkaline urine, and two that form in varying pH. Give descriptions of each of the crystal's microscopic appearance. - ANSWER-Acidic Only 1) Amorphous urates: granular precipitate 2) Uric acid: many different shapes but usually rhomboid or diamond. Are yellow to yellow brown in color. 3) Leucine: yellow or brown. Pin cushion or wheel shaped. 4) Tyrosine: dark refractive needle projections; clustered. 5) Cystine: thin, flat hexagons Alkaline Only 1) Amorphous phosphate: granular precipitate 2) Calcium Carbonate Neutral or varying 1) Sulfonamide: acidic or neutral. Dark, round, crystals radiate from the center 2) Ammonium biurate: slightly acidic/neutral/or alkaline urine. Brown with long or irregular spicules like a thorn apple. 3) Calcium oxalate dehydrate: acidic, neutral, or alkaline. Small squares with an X on the back of the crystals. 4) Calcium oxalate monohydrate: acidic, neutral, or alkaline urine. Dumbbell shaped or elongated with pointed ends. 5) Calcium carbonate: neutral or alkaline urine. Round with lines radiating from the center or dumbbell shaped. 6) Triple phosphate: mostly alkaline, slightly acidic, neutral Your assessment of Noodle identifies altered urinary output. Provide three interventions you should initiate. Technician driven, not vet driven interventions while Noodle is still in the hospital. - ANSWER-Monitoring vital signs, performing urinalysis, giving fluids, or recording urinary output per order of DVM, monitoring for pain or discomfort, ensure preoperative compliance, give urinary specific diets as ordered. What is normal urinary output for a dog each day? - ANSWER-For a dog, it is 20-40 mL/kg per day What client education should you give before Noodle is released to the owner? - ANSWER-Give all client information relating to any prescribed medications, and shown how to administer the medications. Send home urinary specific diets and make sure nothing else bit this diet is fed. Additionally, tell the owner to monitor the incision for any igns for infection and to take the dog out to urinate frequently. What factors can influence the difficulty or ease of parturition? - ANSWER-Nutrition, age, pelvic diameter, gestation length. Then consider the size and presentation of the fetus. What are the different stages of calving? How long should each stage last? - ANSWER-Stage 1: Uterine contractions and dilation of the cervix characterize first stage. Lasts 1-24 hours. Ends with the passing of a part of the fetus into the vaginal canal. Stage 2: Second stage is passing of the fetus into the vaginal canal. Ends when passing of the fetus from the vaginal canal. Should last 1-4 hours with most mature cows delivering within 3 hours. Stage 3: Final and third stage is passing of the fetal membranes which typically occurs within 12 hours. Why would thoroughly cleaning the cow be important in this situation? - ANSWER-Vet must place arm into the cow's vagina and somewhat within the uterus. It is important to minimize bacterial or other contamination of this area. Contamination can cause pyometra or other infection after parturition. What does it mean for a calf to be presenting breech? What is normal calf presentation? - ANSWER-Breech presentation means that the calf is entering the vaginal calf backwards with rear end first. Normal calf presentation is forelegs first in the diving position. What are you using to clear the calf's airway and what are some methods used to clear it? - ANSWER-1) Not usual for calves to get membranes in or covering the respiratory tract. Some calves may also inhale meconium. 2) Most frequently a piece of straw is inserted into the nostril to stimulate breathing. Rubbing the cow with a towel or blanket can also help stimulate breathing. Some people advocate for holding calf upside down and swinging it some to clear the respiratory passages. What is doxapram used for? Describe how you would administer the medication sublingually. - ANSWER-1) Doxapram is a respiratory stimulant. Acts by stimulating the respiratory center and the receptors on the carotid artery and aorta to increase tidal volume. 2) Doxapram can be just dropped onto the mucous membranes under the tongue. Describe 2 interventions that would be useful in addressing the concern of: Hypothermia - ANSWER-Ensure calf is dry and in an area, that is sheltered to help stay dry. Radiating heat lamp may be also used. Describe 2 interventions that would be useful in addressing the concern of: Hypoglycemia - ANSWER-Ensure hypothermia and septicemia concerns are met and ensuring dam is producing milk replacer is available Describe 2 interventions that would be useful in addressing the concern of: Septicemia - ANSWER-Keeping calf clean and uncrowded. Give colostrum and other vaccinations/antitoxins are helpful. Keep umbilical area disinfected with anti-bacterial like iodine. Describe 2 interventions that would be useful in addressing the concern of: Diarrhea - ANSWER-Related to ensuring passive transfer of colostrum, vaccinate calf, and providing proper nutrition. Give extra fluids and electrolytes if having diarrhea Describe 2 interventions that would be useful in addressing the concern of: Mismothering - ANSWER-Best way to prevent this is leaving calf alone as much as possible, allow dam and offspring to bond, keep area quiet and minimize traffic Describe how you would prepare cow for the caudal epidural - ANSWER-Preparation includes clipping rectangle from 3rd coccygeal vertebra to mid-sacrum, scrubbing with surgical soap, rinsed with water or isopropyl alcohol. Knowing that glycerol happens to be hypertonic, what would happen physiologically to the uterine tissue when glycerol is applied? - ANSWER-1) Glycerol is added to reduce edema and reduce size of uterus allowing reduction of uterus 2) Glycerol being hypertonic will draw fluid out of the tissue and reduces the amount of fluid in the uterus What does oxytocin do to the tissues of the uterus? - ANSWER-Oxytocin helps to firm up the uterus by increasing uterine tone and will decrease chance it will prolapse again. What advice should you give Mrs. West? If Skip had some of the antifreeze on his feet or coat, what should you advise Mrs. West to do? - ANSWER-1) Mrs. West should bring Skip into clinic, collect vomit if vomits. Any topical exposure to toxin should be bathed quickly if still alert in mild dishwashing liquid. 2) Always tell them to bring in pet quickly and exercise caution around as they can become aggressive. Identify toxins as quick as possible. 3) Owner should not induce vomiting as this can be harmful as some toxins can cause more danger if vomited up. How long can it take for apomorphine to be effective? What should be done after the dog vomits when using apomorphine? - ANSWER-Apomorphine can take 10 minutes if given IV and up to 20 minutes through other routes. If dog vomits, remaining drug is washed out with saline to minimize irritation When would induction of vomiting be contraindicated? - ANSWER-Vomiting should not be induced when it has been ingested as a caustic substance or CNS stimulant. Also, animals having a seizure or are comatose, dyspneic, hypoxic, or lacking normal phartngeal reflexes should not be given. Syrup of ipecac, salt, liquid dishwashing soap, and xylazine are other methods of inducing vomt. Why is intubation important when performing a gastric lavage? Describe the equipment needed for this procedure ad how to perform a gastric lavage. - ANSWER-1) It is important to minimize risk of aspiration. 2) Gastric lavage includes orogastric tube, isotonic fluids, suction. 3) Gastric lavage is measuring tube by measuring nose to level of last rib and marking its location. Carefully pass into esophagus of intubated animal. Tube placement verified by smelling end of tube, blowing into it and listening for gurgling, and palpating it. Stomach contents evacuated by suction or gravity. Isotonic solution is then infused - keep head elevated. Rock patient back and forth. Given several more times then rock back and forth each time and evacuate contents every time. Meds can be given through tube. Kink tube and carefully withdrawn If Skip's weight is 15 pounds, how much lavage solution can be given at a time? - ANSWER-6.8kg x 5-6mL/kg = 34-41mL How can activated charcoal be beneficial when treating for toxicities? - ANSWER-Intestinal absorbent because it blocks intestinal absorption of toxins. Can block rest of the antifreeze that was not removed when doing lavage. You use an IV pump to regulate the amount of IV fluids for skip. How many mL/hr should Skip receive? - ANSWER-21.25mL/hr What are three technician evaluations related to ethylene glycol toxicity? - ANSWER-client knowledge deficit, altered urinary production, electrolyte imbalance, altered mentation, self-care deficit After Skip finished with treatments, Mrs. West tells you that she heard that chocolate is toxic to dogs. She wants to know if there are any other human foods that are toxic to dogs. Answer. - ANSWER-Baking chocolate, raw bread dough, grapes/raisins, moldy foods, mushrooms Mrs. West asks you what chemicals she should be concerned about around her house and garage. Educate her about the certain chemicals that she should be concerned about. - ANSWER-Many different chemicals including insecticides like pyrethrin or organophosphates, snail bates, metals, household medical supplies, zinc from pennies, lead from batteries, galvanized metal, rat poison, household cleaners like bleach or soap, medications such as acetaminophen. Put all chemicals in a place where Skip cannot access them. Mrs. West tells you that she once heard that rhododendrons were toxic to dogs and she wants to know if that is true and wants to know what other plants can be toxic to dogs. What would you respond - ANSWER-1) yes, rhododendrons are toxic to dogs 2) harmful but not fatal plants include: spider plant, snake plant, peppers, lady of the night, dragon tree 3) fatal plants include: cannabis, lilly of the valley, holly, mistletoe, daffodils What is Sarcoptes? What does it look like? What species can Sarcoptes infest? Why didn't you find Sarcoptes on the last skin scraping? - ANSWER-1) Sarcoptes is a mite. 2) Round, oval with long unjoined pedicles with suckers at ends. No distinctive head and four short stubby legs. 3) Infests many species including: dogs, cats, pigs, cattle, sheep, humans 4) Difficult to collect on scraping and must do it multiple times What are some other mites that are common in dogs? How would the methods of collection vary for finding these other mites? - ANSWER-Otodectes = swab Demodex = skin scrape - scrape deep and narrow, then pinch Sarcoptes = skin scrape - scrape shallow and narrow, then pinch Cheyletiella = cellophane tape What are three technician evaluations you would assign to Daisy? - ANSWER-impaired tissue integrity, risk of infection, risk of infection transmission, acute pain, self-inflicted injury, client knowledge deficit What would you tell Mr. Glover? - ANSWER-Sarcoptes is zoonotic, so the mite can be transmitted to other family members in the household Where are the anal glands located? Do all dogs require anal gland expression? What are two methods to express anal glands? Describe them. - ANSWER-1) Lateral to anus at 4 and 8 'o clock 2) Not at dogs required expression. Some express during defecation 3) Externally: put on exam gloves, cover anus with paper towel, apply pressure cranially to peritoneum and collect excretions Internally: put exam gloves on, insert gloved finger into anus, squeeze gland between finger and thumb, milk the gland and collect excretion When doing a physical exam on or moving HArry, how would you restrain him? - ANSWER-Holding front shoulders and neck areas, support hind end. Can use a towel with little restraint. Are Harry's temperature, heart rate, and respiratory rate within normal limits? - ANSWER-Yes What is an average weight for a guinea pig? Is Harry within the average range? - ANSWER-Normal = 900-1200 grams. Harry is not within the range and is obese. Given Harry's BCS, what advic should you give Mrs. Reid? If alphalfa pellets are 18% minimum protein and 3.5% minimum fat and timothy hay pellets are 14% minimum protein and 1.5% minimum fat, which one would be better for Harry? Why? - ANSWER-Harry is obese and should have diet changes. Harry should not be fed ad lib and have a regular eating schedule. Timothy hay is preferred because it has less calories and less fat. What vitamin is required in the guinea pig diet? What are some different ways Mrs. Reid can make sure Harry gets enough of this nutrient? What cautions should you give to Mrs. Reid regarding this nutrient? A deficiency of this nutrient causes what disease? What clinical signs would be seen if this nutrient was deficient? - ANSWER-Vitamin C is required in a guinea pig diet. It is found in many fresh fruits and vegetables. Commonly supplemented in pellets or formulas that can be placed in the water. Must be changed daily in water. Scurvy is diseased caused by lack of vitamin C. Clinical signs include: painful locomotion, weight loss, anorexia, lethargy, poor hair coat What would you advise Mrs. Reid regarding Harry's housing? - ANSWER-Solid bottom is best as it minimizes foot trauma and skin disease. Pine is not ideal as both soft and cedar emit aromatic hydrocarbons which may impact the liver. Better options include newspaper, paper, hard wood sawdust, corn cob, or hard wood chips. Should also have a box to hide in. Should also keep in quiet area and out of direct sunlight. Would you make any recommendations to Mrs. Reid's watering system for Harry? How often should the water be changed? Why? - ANSWER-Changing water daily is ideal to prevent contamination. No changes are needed. What would you recommend she do with Harry when transporting him? - ANSWER-Small mammals should be transported in a carrier or box to prevent escape or injury to other animals What would you tell Mrs. Reid regarding Harry's nails? What grooming needs do guinea pigs have? How do you trim the nails of a guinea pig? - ANSWER-Guinea pigs have few grooming needs, but do need to have nails trimmed to minimize tearing or infection. Use a human nail clipper and clip in very small increments to avoid the quick of the nail. Of the two female guinea pigs, which one would you recommend being bred to Harry? - ANSWER-Breed Harry with Jill and not Sally. Pelvic symphysis fuses in sows over 6-7 months of age. How would you restrain the guinea pig for an abdominal radiograph series? - ANSWER-Radiographed similar to cats and dogs. Hold on back with hind and front limbs extended for ventrodorsal and lateral with legs extended for lateral. What is an average guinea pig gestation period? What should Mrs. Reid expect from the offspring? When should the babies begin eating hay? When will they be fully weaned? - ANSWER-gestation period = 68 days babies born fully haired, eyes open and active they begin eating hay the second day of life while still nursing they are weaned by 14-21 days of age